Osteonecrosis of the femoral head is a disabling condition affecting young patients and treatment of the disease in these
patients is variable. We retrospectively reviewed 39 patients (43 hips) in whom a modified transtrochanteric rotational osteotomy
was performed for osteonecrosis. The minimum followup was 24 months (mean, 36.6 months; range, 24–52 months). The mean patient
age was 34.3 years (range, 20–51 years). Based on the ARCO classification, 17 hips were classified as Stage II and 26 as Stage
III. We performed rotational osteotomy alone in 15 cases, in combination with simple bone grafting in three, and in combination
with muscle-pedicle-bone grafting in 25. Sixteen of 17 ARCO Stage II cases and 24 of 26 ARCO Stage III cases had no progression
of collapse or lesion size; three hips progressively collapsed. Of the 40 hips without progression the Harris hip score improved
from a mean 70 to 92 points at final followup, as did the range of motion of the hip. Modified transtrochanteric rotational
osteotomy is an effective method for delaying the progression of collapse in the treatment of selected cases of osteonecrosis
of the femoral head.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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